Individual
DR. JON W. CONRAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
808 WILLOW ST, COFFEYVILLE, KS 67337-5851
(620) 251-3920
(620) 251-3923
Mailing address
808 WILLOW ST, PO BOX 374, COFFEYVILLE, KS 67337-5851
(620) 251-3920
(620) 251-3923
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5417
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08906
BLUE CROSS BLUE SHIELD
KS
Enumeration date
02/03/2006
Last updated
01/23/2015
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